The invention relates to a uterus manipulator, in particular for laparoscopically assisted vaginal hysterectomy.
With the combined operative removal of the uterus carried out laparoscopically and through the vagina (LAVH—laparoscopically assisted vaginal hysterectomy), one requires an instrument set which among other things comprises a uterus manipulator, with which the uterus from the outside, may be led through the vagina by a probe introduced through the cervical canal. Such a uterus manipulator is known for example from U.S. Pat. No. 5,520,698. This instrument, additionally to the probe, yet comprises a bell which is open at the distal end and which serves for receiving the cervix and improves the leading of the uterus through the instrument. The bell is provided with lateral openings. A vaginal seal is provided on the proximal side of the bell and at a distance to it and is formed by an inflatable balloon ring, which is to be applied in a sealing manner onto the vaginal wall and ensures that after severing the rear fornix, the pneumoperitoneum is maintained, in order to counteract a collapse of the abdomen.
Such uterus manipulators are considered as part of the prior art and are provided by various manufacturers in different designs. In this regard, it is further considered as part of the prior to design the probe as a hollow probe and thus to carry out a suctioning of intrauterine cells during the operation to avoid the spread of carcinogenic cells.
However, it has been found that this intrauterine cell suctioning is inadequate, in particular with the previously described instrument, with which a balloon is likewise inflated for fixing the probe there within the uterus. The inflating of this inner balloon is, however, necessary in order to ensure a secure retention of the probe within the uterus and thus to ensure a secure leading of the uterus from the outside by the manipulator.